Y. pestis is endemic in several rural areas in the world where it infects wild rodents and can be transmitted to humans by fleas. Untreated pneumonic plague, if not diagnosed and treated early, can be fatal. Plague is infamous for killing more than 50 million people in Europe during the fourteenth century. report that only four genetic changes in the progenitor species, Yersinia pseudotuberculosis, enabled transmission by flea vectors. The organism is transmitted to humans who are bitten by fleas that have fed on infected rodents or by humans handling infected animals. Yersinia pestis can be transmitted to humans from the bites of inflected fleas or handling of plague-infected tissues. Yersinia pestis est une bactérie résistante dans le milieu extérieur dans certaines conditions (basse température, humidité, absence de lumière), ce qui maintient des foyers naturels de peste dans le monde. If these bacteria-containing droplets are breathed in by another person they can cause pneumonic plague. 15 mg/kg/dose every 12 hours (maximum 400 mg/dose), 20 mg/kg/dose every 12 hours (maximum 500 mg/dose), Weight < 45 kg: 2.2 mg/kg twice daily (maximum 100 mg/dose) Weight ≥ 45 kg: same as adult dose, Bacteriostatic, but FDA approved and effective in a randomized trial when compared to gentamicin, 25 mg/kg every 6 h (maximum daily dose, 4 g), Not widely available in the United States, Weight < 45 kg: 2.2 mg/kg twice daily (maximum daily dose, 200 mg), 20 mg/kg twice daily (maximum daily dose, 1 g). Plague then spread from urban rats to rural rodent species, and became entrenched in many areas of the western United States. In the urban and sylvatic (forest) cycles of Y. pestis, most of the spreading occurs between rodents and fleas. Y. pestis exhibits dramatically different traits of pathogenicity and transmission, albeit their close genetic relationship with its ancestor-Y. Prairie dogs 6. The disease can also result by inhaling contaminated aerosols or from direct contact with infected animal tissue. google_ad_client: "ca-pub-9759235379140764", Rodents are the primary hosts of the bacteria, which is spread through fleas. Yersinia pestis is transmitted to humans by the bite of rodent fleas or more rarely from infected domestic cats, handling of infected animal tissue, inhalation of aerosolized droplets, or from laboratory exposure. FDA approved based on animal studies but limited clinical experience treating human plague. Yersinia pestis is an obligate parasite, meaning that it cannot reproduce without a host. It is this third that is the root cause of all three instances of plagues going global causing humongous human and economic damage. Y. pestis is evolved into a deadly pathogen and transmitted to mammals and/or human beings by i … Prairie dogs 6. Humans usually get plague after being bitten by a rodent flea that is carrying the plague bacterium or by handling an animal infected with plague. Contact your local health department if you have questions about disposal of dead animals. Active long-term surveillance of animal foci, coupled with a rapid response during animal outbreaks has successfully reduced numbers of human plague outbreaks. Transmission can take place if someone breathes in Y. pestis particles, which could happen in an aerosol release during a bioterrorism attack. If you are experiencing symptoms like those listed here, seek immediate medical attention. Plague can be a very severe disease in people, particularly in its septicemic and pneumonic forms, with a case-fatality ratio of 30%-100% if left untreated 2). Perry R, Fetherston J. Blood cultures: Organisms may be seen in blood smears if the patient is septicemic. PEP should be given only when the benefits outweigh the risks. One serum specimen should be taken as early in the illness as possible, followed by a convalescent sample 4-6 weeks or more after disease onset. Annually, most human cases occur in Africa, with Madagascar considered to be the most highly endemic country. Blood smears taken from suspected bubonic plague patients early in the course of illness are usually negative for bacteria by microscopic examination but may be positive by culture. Post-exposure prophylaxis is indicated in persons with known exposure to plague, such as close contact with a pneumonic plague patient or direct contact with infected body fluids or tissues. The researcher studied the genetics of harmful bacteria, including a … Yersinia pestis is a zoonotic bacteria that causes plague or the Black Death during medieval times, that is most commonly transmitted through fleas that feed on infected rodents. The strain had not been known to have caused laboratory-acquired infections or human fatalities. Scientists think that plague bacteria circulate at low rates within populations of certain rodents without causing excessive rodent die-off. VolesThe bacteria can also enter your body if a break in your skin comes into contact with an infected animal's blood. Yersinia pestis is the causative agent of plague, a devastating disease that in three pandemics resulted in more human deaths than any other infectious agent has (45, 69). agent of bubonic plague. strain (KIM D27). Dogs and cats may also bring plague-infected fleas into the home. The three most endemic countries are the Democratic Republic of Congo, Madagascar, and Peru. As an animal disease, plague is found in all continents, except Oceania. Remove brush, rock piles, junk, cluttered firewood, and possible rodent food supplies, such as pet and wild animal food. Yersinia pestis, which causes bubonic plague, forms biofilms in fleas, its insect vectors, as a means to enhance transmission. The flea ingests the organism while feeding on a bacteremic host. In many cases, particularly in septicemic and pneumonic plague, there are no obvious signs that indicate plague. Buboes are often so painful that patients are generally guarded and have restricted movement in the affected region. Centers for Disease Control and Prevention. Reported Cases of Human Plague in United States 1970-2016. Many types of animals, such as rock squirrels, wood rats, ground squirrels, prairie dogs, chipmunks, mice, voles, and rabbits can be affected by plague. Dogs and cats may also bring plague-infected fleas into the home. After being taken up by macrophages, the bacteria proliferate in the affected lymph nodes, causing inflammation and swelling to occur, i.e., buboes. Although the majority of patients with plague present with a bubo, some may have nonspecific symptoms. Plague symptoms depend on how the patient was exposed to the plague bacteria. Sick cats pose a risk of transmitting infectious plague droplets to their owners or to veterinarians. Transmission of these droplets is the only way that plague can spread between people. Providing masks for pneumonic patients can reduce spread. Yersinia pestis, the cause of bubonic and pneumonic plague in humans, persists in populations of wild rodents in many parts of the world and is transmitted primarily by the bites of infected fleas . Available from: https://www.ncbi.nlm.nih.gov/books/NBK45744, Human Plague – Four States, 2006. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5534a4.htm. Recommended antibiotic treatment for plague. Rabbits 5. These infected animals and their fleas serve as long-term reservoirs for the bacteria. A downloadable version pdf icon[PDF – 1 page] is also available. Sun et al. Yersinia pestis, the bacterial agent of bubonic and pneumonic plague, is one of the most virulent human bacterial pathogens and is well known historically for its ability to cause devastating pandemics.Plague remains an international public health concern and periodically re-emerges in the form of sudden large outbreaks. Rats 2. Larger areas can be disinfected using 10% of diluted household bleach (made fresh daily). Yersinia pestis bacteria can cause plague, which is an acute, infectious disease. Reduce rodent habitat around your home, work place, and recreational areas. In Madagascar cases of bubonic plague are reported nearly every year, during the epidemic season (between September and April) 4). Isolate patients with pneumonic plague. Yersinia pestis, the plague bacteria can be transmitted to humans in the following ways: Yersinia pestis bacteria are most often transmitted by the bite of an infected flea. Spraying of face/chest area of suspected pneumonic plague deaths should be discouraged. Being that a rat is a bigger organism and … Figure 5. Plague – Resources for Clinicians. Plague occurs in rural and semi-rural areas of the western United States, primarily in semi-arid upland forests and grasslands where many types of rodent species can be involved. https://www.cdc.gov/plague/healthcare/clinicians.html. A person with pneumonic plague may experience high fever, chills, cough, and breathing difficulty and may expel bloody sputum. We developed a pentaplex real-time PCR assay that not only detects both Yersinia species but also differentiates Y. pestis strains regarding their plasmid profiles. Plague ecology in the United States. Epizootics are most likely in areas with multiple types of rodents living in high densities and in diverse habitats. You will be subject to the destination website's privacy policy when you follow the link. Contact with contaminated fluid or tissue. Yersinia pestis, the causative agent of plague. Humans are usually infected through bites from rodent fleas that carry the disease. Northern New Mexico, northern Arizona, and southern Colorado, California, southern Oregon, and far western Nevada. Patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. CDC twenty four seven. Yersinia pestis is a Gram-negative, non-motile, non-spore-forming coccobacillus that is also a facultative anaerobe 1). Other articles where Yersinia pestis is discussed: plague: >Yersinia pestis, a bacterium transmitted from rodents to humans by the bite of infected fleas. Treatment of plague with gentamicin or doxycycline in a randomized clinical trial in Tanzania. Yersinia pestis, the causative agent of plague, is proved to be a recently emerged clone from Y. pseudotuberculosis. Recommended antibiotic treatment of pregnant women for plague. Squirrels 4. Transmission Fleas are natural vectors (carriers) of Y. pestis , and the bacteria are typically transmitted to and among rodents via flea bite. Wild carnivores can become infected by eating other infected animals. Additional rare forms of plague include pharyngeal, meningeal, and cutaneous. Recommended antibiotic treatment of children for plague, Table 3. Usually this begins one to seven days after exposure. During the first week after being taken up by a flea in a blood meal, the bacteria multiply in the … edited August 2015 The Yersinia pestis infection guidelines were first published in the J Feline Med Surg 2013; 15: 582-584 by Maria Grazia Pennisi. Plague has occurred in people of all ages (infants up to age 96), though 50% of cases occur in people ages 12–45. In parts of the developing world, plague can sometimes occur in urban areas with dense rat infestations. A downloadable version pdf icon [PDF – 1 page] is also available. Sick cats pose a risk of transmitting infectious plague droplets to their owners or to veterinarians. Without proper antibiotic treatment, infection by Yersinia pestis led to death within a few days. A specific Yersinia pestis antigen can be detected by different techniques. 2. The most common sign of bubonic plague is the rapid development of a swollen and painful lymph gland called a bubo. The infection exists in three major plague forms: bubonic, septicemic, and pneumonic. A University of Chicago researcher died Sun., Sept. 13, at the Medical Center's Bernard Mitchell Hospital from an infection which may be attributable to a weakened laboratory strain of Yersinia pestis, the bacteria that causes the plague.. See WHO map of global cases. Pneumonic plague, or lung-based plague, is the most virulent form of plague. Inform and train them on infection prevention and control. During plague epizootics, many rodents die, causing hungry fleas to seek other sources of blood. Transmission of these droplets is the only way that plague can spread between people. Saving Lives, Protecting People, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), U.S. Department of Health & Human Services. The plague bacteria, Yersinia pestis, is transmitted to humans through the bites of fleas that have previously fed on infected animals, such as: 1. Plague is a plausible diagnosis for people who are sick and live in, or have recently traveled to, the western United States or any other plague-endemic area. Mwengee W, Butler T, Mgema S, Mhina G, Almasi Y, Bradley C, Formanik JB, Rochester CG. The area should be covered with a disinfectant-soaked cloth or absorbent material. Chipmunks 7. Epidemic; The epidemic pattern of Plague transmission is largely of historical significance. Transmission to humans is usually through the bite of infected fleas. Typically this requires direct and close contact with the person with pneumonic plague. In the bubonic form there is also swelling of lymph nodes, while in the septicemic form tissues may turn black and die, and in the pneumonic form shortness of breath, cough and chest pain may occur. Once plague has been identified as a possible cause of the illness, appropriate treatment should begin immediately. }); 5 mg/kg once daily, or 2 mg/kg loading dose followed by 1.7 mg/kg every 8 hours, Not FDA approved but considered an effective alternative to streptomycin. 2004 38(5):663-669. Without prompt treatment, plague can cause serious illness or death, with a case-fatality ratio of 30% to 100% if left untreated. Use repellent if you think you could be exposed to rodent fleas during activities such as camping, hiking, or working outdoors. Any person with pneumonic plague may transmit the disease via droplets to other humans.
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